A comparison of GIT toxicity of the BEAM and TEAM conditioning before autologous transplantation in patients with lymphomas

GIT toxicita přípravných režimů

Abstract

As a standard conditioning before administration of autologous hematopoietic cell transplantation (ASCT) in relapsed or refractory lymphomas was used BEAM regimen, i.e. carmustine (BCNU) in combination with etoposide, cytarabine and melphalan. However, the recent lack of BCNU has led to the search for an alternative regimen, which in our center became from July 2018 the regimen containing thiotepa, the so-called TEAM. We decided to retrospectively compare the gastrointestinal (GIT) toxicity of both conditionings. We included 142 consecutive autologous transplant patients (BEAM = 82, TEAM = 60), of whom 31 % had diffuse large B-cell lymphoma (DLBCL), 20 % Hodgkin's lymphoma (HL), 15 % mantle cell lymphoma (MCL), 14 % T-cell lymphomas (T-NHL) and the remaining 20 % other types of non-Hodgkin lymphomas (NHL). Both cohorts were comparable in terms of patient age, prevalence of diagnoses, and disease status at the time of ASCT. After comparing the severity of GIT toxicity, no statistical difference was found between the two cohorts. No or only very mild GIT toxicity (grade 0-I) was present in 53 pts. (64 %) after BEAM vs. 28 pac. (46 %) after TEAM (p = 0.32). Grade II GIT toxicity occurred in 11 (14 %) vs. 12 pac. (20 %) (p = 0,49), grade III in 12 (15 %) vs. 16 pac. (27 %) (p = 0.21) and finally the most severe grade IV in 1 (1 %) vs. 3 pac. (5 %) (p = 0.32). Patients receiving the TEAM regimen were more likely to require parenteral nutrition, exactly in 20 cases (33 %) versus only 13 cases (16 %) in the BEAM regimen (p = 0.04). Non-relapse mortality (NRM) was comparably low for both regimens, it was 0 % during hospitalization and 2 % at 3 months for both conditionings (p = 1.0).